高原肺水肿发病机制及防治研究进展

Pathogenesis,prevention and treatment of high altitude pulmonary edema:research advances

高原肺水肿是由于快速进入高原(一般海拔≥2500 m)因缺氧而引起的非心源性肺水肿,为高原地区特发病及常见病,严重威胁人类的健康。其发病机制复杂,可能是由于通气/血流比例失调、化学感受器异常变化、水通道蛋白减少、肺微血管变化以及基因等多种因素共同作用导致的,至今仍不完全清楚。治疗高原肺水肿主要应尽快脱离低压缺氧环境,并配合吸氧或服用利尿剂、激素等能降低肺动脉压的药物,严重时要联合用药。本文介绍了高原肺水肿的流行病学特征、各种发病机制的研究以及防治高原肺水肿的手段、方法和药物,以期能对相关医务人员和从事高原活动的人群提供参考。

High altitude pulmonary edema is a fatal acute non-cardiogenic pulmonary edema caused by the environment of low pressure and hypoxia, when people have their fast access to the plateau （general elevationS2500 m）. It is a serious threat to human health. Pathogenesis of high altitude pulmonary edema is still not entirely clear and may be due to ventilation/perfusion imbalance, chemical receptors changes, water channel protein decreased, pulmonary microvascular changes and genes. Treatment of high altitude pulmonary edema should be mainly far away from the environment of low pressure and hypoxia as soon as possible, and comply with ox- ygen or take diuretics, hormones and other drugs reducing pulmonary artery pressure. This article describes the epidemiological characteristics, the studies of the pathogenesis and the methods of prevention and treatment of high-altitude pulmonary edema in order to provide a reference for the relevant medical staff and people engaged in activities plateau.